RT-MRI is safe and equally capable as VF to identify the cause of dysphagia in IBM. Advantages of RT-MRI include visualization of soft tissue, more reliable timing analysis, and lack of X-ray exposure. RT-MRI may become a routine diagnostic tool for detailed assessment of the esophagus and other moving parts of the body, facilitating longitudinal evaluations in daily practice and clinical trials.
Purpose: To evaluate the use of a novel real-time magnetic resonance imaging (MRI) technique for the assessment of normal swallowing dynamics. Materials and Methods:In a cohort of 10 healthy subjects, real-time MRI movies at 24.3 frames per second were obtained in sagittal, coronal, and axial orientation during self-controlled swallows of 5 mL pineapple juice as oral contrast bolus. All studies were performed with the use of a commercial MRI system at 3 T combining two sets of radiofrequency receiver coils. Real-time movies relied on a fast low-angle shot (FLASH) MRI sequence with radial undersampling and image reconstruction by nonlinear inversion yielding 41.23 msec acquisition time for an in-plane resolution of 1.5 mm. Evaluations focused on clinical image quality as well as visualization and temporal quantification of distinct swallowing functions.Results: Throughout the entire process, the swallowing dynamics were well depicted and characterized with almost no visible image artifacts in all subjects. The midsagittal plane turned out to be most valuable. The movies allowed for a quantitative determination of the temporal pattern of all swallowing events. Conclusion:The proposed real-time MRI technique yields noninvasive, robust, and quantitative access to the physiology of normal swallowing in healthy subjects at high temporal resolution and image quality. DYSPHAGIA IS A SERIOUS SEQUELAE in different neurological diseases as well as in functional disorders due to posttreatment deficits after surgery, radiotherapy, or chemotherapy. The problem is twofold: while the clinical evaluation seeks detailed access to the timing, direction, and efficiency (clearance) of swallowing, the technical approach should be safe and quick as well as robust and reliable (1,2).The gold standard for swallowing diagnostics is videofluoroscopy, with a typical temporal resolution of at least 25 frames per second (fps). The whole process of deglutition can be visualized in a coronal or sagittal plane. Its disadvantage is the x-ray exposition of the patient and the missing axial plane. Accordingly, flexible endoscopic evaluations of swallowing (FEES) have gained diagnostic importance due to their reduced invasiveness, simplicity, and low cost. On the other hand, FEES suffers from the well-known ''white out'' during the pharyngeal phase, which is of greatest interest (3).The aim of this study was to evaluate the performance of a recently introduced real-time magnetic resonance imaging (MRI) technique with high temporal resolution (4) to study deglutition in normal subjects. MATERIALS AND METHODS SubjectsTen normal volunteers (four men, six women; age 28 6 3 years [mean 6 standard deviation]; range 26-35 years), with no history or presence of dyspnea, dysphonia, and dysphagia were recruited from the local university. The whole study was approved by the Institutional Review Board and all participants gave written informed consent before each examination. Absence of any swallowing or oro-mandibular dysfunction was ensured by the personal m...
Our observations point to two different cortical motor representation areas, with the cricothyroid muscle-related area being located more medially.
The Göttingen hoarseness diagram is suitable for a qualitative assessment even of irregular voices. Voice prosthesis offers a voice quality that at best approaches that of patients with partial laryngectomy.
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